August 12, 2013

Anxiety Disorder Linked To Childhood Abdominal Pain

Researchers from Vanderbilt University in Tennessee found that children who experience abdominal pain are more likely to suffer from an anxiety disorder.

Publishing their findings in the journal Pediatrics, the researchers suggest that parents may want to have their children evaluated for a psychological disorder if they are having chronic, unexplained stomach pains. The researchers also found that just over half of kids with stomach pain had symptoms of an anxiety disorder at some point by the time they had reached 20 years old, with social anxiety being the most common.

"What was striking was the extent to which anxiety disorders were still present at follow-up," study co-author Lynn Walker, a pediatrics expert at the university, told Genevra Pittman of Reuters Health.

The study included over 330 successive pediatric abdominal pain patients from a single healthcare center and almost 150 similar-aged children who did not develop abdominal problems. Researchers followed up on both groups between 4 to 16 years later, when the study participants’ average age was around 20 years old.

During follow-up visits, 41 percent of those with abdominal pain had been determined to have some kind of gastrointestinal disorder. Researchers also found anxiety disorders in 30 percent of the abdominal pain group at follow-up, compared with 12 percent of the control group.

The Vanderbilt team found an even greater connection for lifetime anxiety disorders, 51 percent versus 20 percent for the control group. Lifetime depressive disorders were seen in 40 percent of the abdominal pain patients compared with 16 percent in the other group.

The report cited an even greater risk for psychological issues among those who still had a gastrointestinal disorder, a 7.31-fold increase for lifetime anxiety disorder and 4.14-fold increase for lifetime depressive disorder.

Walker said children with anxiety may be more susceptible to pain, and subsequently more stressed about any pain they do feel.

"People who are anxious tend to be very vigilant to threat, scanning their environment or their body for something that might be wrong," she said.

These children are at-risk for entering a "vicious cycle" of avoiding social situations at school, staying home from school more often, getting behind on schoolwork and becoming even more anxious, she added.

Dr. Eva Szigethy, head of the Medical Coping Clinic at the Children's Hospital of Pittsburgh Inflammatory Bowel Disease Center, told Reuters Health that Walker's study findings are significant – given the prevalence of reported abdominal pain among kids.

"It's very prevalent, and it's one of the most common reasons that children and adolescents end up in their pediatrician's office. It's one of the most common reasons kids are missing school," said Szigethy, who was not involved in the Vanderbilt study.

Study researchers noted several limitations to their findings – including inconsistent follow-up visits and not including social factors that could be contributing to patients’ depression and anxiety.

Szigethy added that the study didn't track patients’ treatments for anxiety or stomach pain, suggesting that is "a next step to be looking at in this type of work."